Hand, foot, and mouth disease (HFMD) is a common infectious disease caused by a range of enteroviruses, with Coxsackie A16 virus being the most common, but it can also be caused by Enterovirus 71 and other enteroviruses. It’s mostly common in children under 10 years old, but it can also affect older children and adults.

This disease is characterized by fever, sore throat, and a feeling of being unwell (malaise), followed by painful sores or blisters in the mouth and red spots or rashes on the hands and feet. The spots may turn into blisters, and are usually located on the palms of the hands and soles of the feet, hence the name of the disease.


HFMD is usually mild and self-limiting, meaning most people recover on their own without specific treatment, typically in 7 to 10 days.

The disease spreads easily through person-to-person contact such as touching a contaminated surface, close personal contact, the air during a cough or sneeze, feces, and contact with blister fluid. Therefore, good hygiene, like thorough hand washing and cleaning common areas, is key to preventing the spread of the disease.

There is no specific cure for HFMD but symptoms can be managed with pain relief medications, staying hydrated and rest. Note that it’s a different condition from the similarly named ‘Foot-and-mouth disease’ that affects cattle, sheep and pigs; humans cannot get the animal disease or vice-versa.

Causes of Hand, foot and mouth disease

Hand, foot, and mouth disease is generally caused by a group of enteroviruses, the most common of which is Coxsackievirus A16. This disease primarily affects infants and children younger than 5 years old.

The viruses that cause hand, foot and mouth disease spread from person to person primarily through contact with an infected person’s:

1. Nasal secretions or throat discharge
2. Saliva
3. Fluid from blisters
4. Stool
5. Respiratory droplets sprayed into the air after a cough or sneeze

Common places for these viruses to spread include at schools and childcare centers, where kids are in close contact with each other, and might not maintain the levels of hygiene that can help to stop the spread of the disease.

In addition to Coxsackievirus A16, several types of enteroviruses may also cause hand, foot, and mouth disease. Outbreaks of the disease are more likely to occur in the summer and autumn in the United States and other temperate climates, but can occur any time of year in tropical climates.

It is important to note that not everyone who are infected with the viruses that cause hand, foot, and mouth disease will get all of symptoms. Some people may only get the rash or the mouth ulcers.

Risk Factors of Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a contagious illness primarily affecting children under the age of 5, however, it can also affect older children and adults. It is caused by enteroviruses, most commonly the Coxsackie A16 virus. Here are the risk factors associated with HFMD:

1. Age: HFMD is most common in children under the age of 10, particularly those under 5 years old. Their immune systems are not fully developed and they may not have been exposed to the viruses that cause HFMD before, hence they’re more susceptible to the infection.

2. Season: HFMD outbreaks are most common in warmer months, i.e. spring, summer and fall.

3. Hygiene: Poor hand hygiene particularly after using the toilet, changing a diaper or before preparing or eating food increases risk of infection.

4. Exposure to infected person: HFMD is contagious, hence close contact with an infected person, their body fluids, or contaminated surfaces increases the risk of transmission and infection.

5. Group settings: Children in daycare or preschool are at a higher risk because of frequent close contact with other children who may be carrying the virus.

6. Immune system: Those with a weak immune system are more susceptible to HFMD.

7. Travel: In recent years, there have been outbreaks of severe HFMD strain in several East and Southeast Asian countries. Travel to these regions might increase risk.

Remember, the best prevention is good hygiene practices, such as washing hands often with soap and water, cleaning and disinfecting frequently touched surfaces, and avoiding close contact such as hugging, kissing, or sharing eating utensils or cups with people with HFMD.

Signs and Symptoms of Hand, foot and mouth disease

Hand, Foot, and Mouth Disease (HFMD) is an infection caused mainly by the Coxsackie virus. It often affects children under 10 years, but people of all ages can contract the disease. Here are the common signs and symptoms:

1. Fever: A high temperature is often the first sign of HFMD. It can come on quite suddenly and make the person feel quite ill.

2. Sore Throat: A sore throat can also be one of the early signs of HFMD. This may also be accompanied by a general feeling of malaise or being unwell.

3. Loss of Appetite: Children affected by HFMD often lose their appetite and may refuse to eat, mainly due to the discomfort in the mouth and throat.

4. Mouth Sores: One to two days after the fever starts, painful sores can develop in the mouth, starting as small red spots. They may blister and then form ulcers.

5. Rash on Hands and Feet: Around the same time as the sores appear, a rash might develop, often on the palms of the hands and the soles of the feet. This rash can present as red spots, sometimes with blisters.

6. Irritability: Especially in younger children, irritability or fussy behavior may also be a sign of HFMD.

7. Poor sleep: The discomfort associated with the disease often leads to sleep disturbances.

If you or your child are showing these signs, it would be a good idea to consult a healthcare professional for a proper diagnosis and treatment plan. It’s important to mention that HFMD can be quite contagious, especially during the first week of illness, so it is recommended to stay at home and avoid close contact with others during this time.

Diagnosis Hand, foot and mouth disease

Hand, Foot and Mouth Disease (HFMD) is an infectious disease predominantly affecting children but can occur in adults. It’s caused by several different types of viruses, but most commonly by the Coxsackievirus A16.

Symptoms begin to appear about 3 to 7 days after exposure to the virus. It typically starts with a fever, reduced appetite, a sore throat, and a feeling of being unwell. One or two days after the fever starts, painful sores can develop in the mouth. They usually begin as small red spots, often in the back of the mouth, that blister and can become ulcers. A skin rash with red spots, and sometimes with blisters, may also develop over 1 to 2 days on the palms of the hands and soles of the feet. It can also appear on the knees, elbows, buttocks or genital area.

Diagnosis typically is based on the presenting signs and symptoms. Doctors can often recognize hand, foot and mouth disease by the characteristic pattern of sores and the age of the person. A throat swab or stool sample may be taken for laboratory testing to confirm the diagnosis.

HFMD is contagious and can spread from person to person through direct contact with unwashed hands or surfaces contaminated with feces. It can also be transmitted through saliva, sputum, or nasal mucus of an infected person.

There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It’s also important to stay hydrated, as the mouth sores can make swallowing painful or difficult.

While it can be uncomfortable, HFMD typically clears up on its own in 7 to 10 days. The best prevention is thorough and regular handwashing, not sharing eating utensils or drinking cups, and disinfecting common areas and objects frequently.

Remember to consult a healthcare professional if you suspect HFMD and especially if the symptoms don’t improve after a few days, become significantly worse, or if the person with HFMD is very young, elderly, or has a compromised immune system.

Treatment of Hand, foot and mouth disease

Hand, foot, and mouth disease (HFMD) is a relatively common infection, often among children, that is caused by a group of viruses. Although it’s typically mild, there are several possible approaches for managing the symptoms and discomfort related to the disease:

1. Over the counter medications: Pain and fever relief medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used under doctor’s instructions to manage symptoms. Aspirin should NOT be given to children, because it’s associated with a risk of developing Reye’s Syndrome, a serious condition.

2. Hydration: HFMD can cause mouth sores that make it painful to swallow and eat, leading to a risk of dehydration. Maintaining fluid intake is crucial. If swallowing is difficult, try sucking on ice or popsicles, or drinking plenty of cold fluids.

3. Rest: A sufficient amount of rest helps the body to recover faster.

4. Mouth rinses or sprays: OTC products can temporarily numb the mouth and provide some relief from the pain of mouth ulcers.

Although there is currently no treatment to eliminate the virus that causes HFMD, addressing the symptoms can significantly improve comfort as the body fights off the illness.

Remember, prevention is also key with hand, foot, and mouth disease. Frequent hand-washing, avoiding close contact with people who are infected, and cleaning common areas and toys can drastically reduce the spread of this illness. Good hygiene is crucial not only in the treatment but also the prevention of HFMD. If symptoms persist or worsen, it is always recommended to seek professional medical advice.

Medications commonly used for Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a common viral illness that typically affects infants and children younger than 5 years old. The disease is caused by several types of viruses, including coxsackieviruses and enteroviruses. Since it’s a viral infection, antibiotics are not effective against it.

Generally, the treatment of HFMD is focused on relief of symptoms (supportive treatment) as the body fights off the virus. Over-the-counter medications can be taken for pain and fever relief. Two common types of medication used are:

1. Analgesics: These are drugs that relieve pain. A common over-the-counter analgesic is ibuprofen (Advil, Motrin IB, others). Aspirin should not be used in children due to the risk of Reye’s syndrome.

2. Antipyretics: These are drugs that reduce fever. Acetaminophen (Tylenol, others) is a common over-the-counter antipyretic.

Also, mouthwashes or sprays that numb mouth pain could be used.

Hydration is important as HFMD can cause individuals to not want to eat or drink, which potentially could lead to dehydration.

Topical medications are also available that can be applied to the sores and help relieve the itching and discomfort associated with these.

Note: Always talk to your healthcare provider or pharmacist before starting any new medication, and read the manufacturer’s instructions carefully.

In severe cases, or if the child is very young, hospitalization may be needed. More targeted antiviral medications might be used in a hospital setting, such as pleconaril. However, these drugs are not typically used in most cases of HFMD.

Again, it is always best to consult with a healthcare provider for advice if you or your child has HFMD, or if you suspect you might have it. They can provide you with the most accurate and up-to-date information.

Prevention of Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a contagious illness typically caused by a coxsackievirus. It is common in infants and children younger than 5 years old, but can also occur in adults. Despite its name, it is not related to foot and mouth disease found in livestock.

Here are some prevention tips for HFMD:

1. Personal Hygiene: The importance of personal hygiene cannot be overstressed. Regular hand washing, especially after using the bathroom, changing a diaper, and before eating can prevent the spread of the disease.

2. Avoid Close Contact: Avoid close contact like hugging, kissing, or sharing utensils with infected people. The disease can easily spread through saliva, the air from a cough, and physical contact.

3. Cleaning and Disinfecting: Regularly clean and disinfect commonly touched surfaces and toys. The virus can live on these surfaces for days.

4. Isolation: If someone in the household is afflicted with HFMD, they should be isolated to prevent the contagion from spreading to others. This may also include staying away from school or daycare until fully recovered.

5. Care with Diapers and Feces: The virus can also be present in feces, so care should be taken when changing diapers of an infected child. Washing hands thoroughly afterwards can prevent the disease’s spread.

6. Avoid Touching Eyes, Nose, and Mouth: People should avoid touching their eyes, nose, and mouth with their hands, especially if they haven’t been washed recently, to prevent the virus from entering their bodies.

7. Vaccines are also available in some countries to protect against HFMD, particularly the strains caused by enterovirus 71.


Remember that while these steps reduce the risk of getting HFMD, they don’t guarantee 100% prevention as the virus can be highly contagious.

FAQ’s about Hand, foot and mouth disease

1. What is Hand, Foot and Mouth Disease (HFMD)?
Hand, Foot and Mouth Disease (HFMD) is a contagious illness caused by different viruses. It is common in infants and children younger than 5 years old.

2. What are the symptoms of HFMD?
Symptoms include fever, loss of appetite, fatigue, and sore throat, followed by painful blisters on the tongue, gums, and inside of the cheeks, a rash of flat red spots that may blister on the palms of the hands, fingers, soles of the feet, and sometimes on the buttocks.

3. How does HFMD spread?
The viruses that cause HFMD can be found in an infected person’s nose and throat secretions (such as saliva or nasal mucus), blister fluid, or feces. They can be spread through close personal contact, through the air when an infected person coughs or sneezes, contact with feces, or contact with contaminated objects.

4. How is HFMD diagnosed?
A healthcare provider can usually diagnose HFMD based on the patient’s age, symptoms, and appearance of the rash and sores. Laboratory tests can also be done to confirm the diagnosis.

5. How is HFMD treated?
There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter medications, but do not give aspirin to children. It’s also important to stay hydrated.

6. Is there a vaccine for HFMD?
Currently, there is no vaccine for Hand, Foot, and Mouth Disease available in most countries, including the U.S.

7. How can HFMD be prevented?
Good hygiene is the best protection: wash hands often with soap and water, disinfect common areas and toys, avoid close contact with those infected with HFMD, and avoid sharing cups and eating utensils.

8. Can adults get Hand, Foot, and Mouth Disease?
Yes, adults can get HFMD, but it’s much more common in children. Some adults might not show any symptoms but they can still pass the virus.

9. Is HFMD the same as Foot and Mouth Disease in animals?
No, HFMD is not related to Foot and Mouth Disease, which affects cattle, sheep and pigs. They are caused by different viruses.

10. Can HFMD reoccur?
Yes, because HFMD is caused by several different viruses, it’s possible to get the disease again.

11. Can HFMD cause complications?
Complications from HFMD are rare, but it can lead to viral meningitis or encephalitis, which is inflammation of the brain. In rare cases, it can also cause a polio-like paralysis.

If you have any concerns related to HFMD, it is recommended to consult a healthcare provider.

Useful links

Hand, Foot, and Mouth Disease (HFMD) is a contagious illness that primarily affects infants and children. It is caused by different viruses, most commonly, the coxsackievirus. Symptoms include a fever, reduced appetite, sore throat, painful sores in the mouth and a skin rash on the hands and feet.

Here are some useful links from journals about HFMD:

  1. https://pubmed.ncbi.nlm.nih.gov/31573162/
  2. https://pubmed.ncbi.nlm.nih.gov/30566537/

Remember, it’s always best to consult with a healthcare provider for the most accurate and up-to-date information.

Complications of Hand, foot and mouth disease

Hand, foot, and mouth disease (HFMD) is a common viral illness that usually affects infants and children under 5 years old. It’s characterized by sores in the mouth and a rash on the hands and feet. The disease is typically mild and without severe complications, but in rare cases, serious conditions may arise. Here are some possible complications:

1. Dehydration: Children afflicted with HFMD may be unwilling or unable to swallow due to the painful mouth ulcers. This can lead to dehydration.

2. Viral or “aseptic” meningitis: In some rare cases, the virus can cause meningitis, an inflammation of the tissues covering the brain and spinal cord. Symptoms may include headache, fever, stiff neck, or sensitivity to light. Most people with viral meningitis recover without long-term problems.

3. Encephalitis: Rarely, HFMD can cause encephalitis, which is an inflammation of the brain. This is a serious condition that can result in short-term memory loss, seizure, paralysis, and even death.

4. Pulmonary edema or pneumonia: This is very rare but potentially life-threatening. It’s most common in newborns who become infected from their mothers just before or after birth.

5. Cardiac complications: In rare cases, the virus may affect the heart, causing myocarditis, a condition characterized by inflammation of the heart muscle.

6. Fingernail and toenail loss: In some cases, about 4 weeks after having hand, foot, and mouth disease, children might lose their fingernails or toenails. This is rare and not everyone will have it. The nail loss is temporary; new nails will grow back without treatment.

Most children recover from HFMD within a week without medical treatment. However, it is important for parents to monitor their children’s symptoms and seek medical attention if the child is unable to drink fluids or if symptoms become severe.

Home remedies of Hand, foot and mouth disease

Hand, foot, and mouth disease (HFMD) is a common viral illness that usually affects infants and children younger than 5 years old. It is caused by a variety of viruses, most commonly the Coxsackie virus. Though it’s often mild and can be managed with over-the-counter pain relievers and time, it’s a discomfort – particularly for children.

While there’s no specific cure for HFMD, home remedies can help manage symptoms. Please consult your or your child’s healthcare provider before initiating any home remedies.

1. Plenty of Fluids: Dehydration can occur due to sores in the mouth making it difficult for the child to drink and eat. Keeping a child well-hydrated helps prevent complications. Try to encourage your child to drink milk, water, or their favorite drink.

2. Cold Foods: Cold foods such as ice cream, yogurt, and smoothies can help numb the mouth and throat area, providing relief from pain caused by sores.

3. Over-The-Counter Pain Relievers: You can give children over-the-counter pain relievers like Acetaminophen (Tylenol) or Ibuprofen (Motrin, Advil) to help with fever and pain, but avoid aspirin in anyone under 18 years of age.

4. Avoid Spicy and Acidic Foods: These types of foods can exacerbate the pain of mouth sores. It’s best to stick to bland and soft foods that won’t require much chewing.

5. Rest and Hygiene: Encourage children to rest to strengthen their immune system and keep them away from communal or crowded places before and after the disease to prevent spreading. Frequently wash hands to prevent further spread.

Always keep in mind that these home treatments help in symptom management; they do not cure the disease and do not prevent transmission of the virus. HFMD is highly contagious, so it’s important to maintain good hygiene within the home to prevent other members of the family from contracting it.

In case of severe pain, high fever, or if signs of dehydration occur, such as dry mouth, decrease in urination, or unusual sleepiness, it’s recommended that you seek immediate medical attention. If symptoms worsen or continue beyond a week, it’s best to contact a healthcare provider.

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Infectious Diseases,

Last Update: January 8, 2024